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Domestic Violence during Pregnancy Survey

This survey is for women of all ages who were pregnant at least once in their lifetime and during pregnancy experienced non-physical or physical abuse from their partner, partner's family or their own family. To be eligible to complete the survey, the pregnancy did not have to come to term nor the baby did not need to survive the pregnancy. If there was a miscarriage, abortion or stillbirth, the pregnancy still counts and the survey can be completed. If you conceived through IVF or were not in a heterosexual (straight) relationship during the pregnancy, the survey can be completed. The only criteria is that you experienced non-physical or physical abuse when your body carried the embryo and or fetus. Our goal in this survey is to understand the generational impact of of abuse during pregnancy and the medical impact of both the mother and child during and post pregnancy. Participants may choose to remain anonymous or provide limited contact information for follow-up interviews at the end of the survey. 

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* 1. You can complete this survey anonymously or with limited contact information to complete at the end. How would you like to complete this survey?

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* 2. In what country do you live?

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* 3. In what state or U.S. territory do you live? If your state or provence is not listed, please select other and name your state or provence.

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* 4. Did you experience non-physical (coercive control, emotional, verbal, psychological abuse, threats, or gaslighting) or physical abuse during pregnancy?

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* 5. How many times have you been pregnant? Please includes all pregnancies. Including pregnancies that ended in miscarriages, abortions and stillbirths.

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* 6. How old were you when you were pregnant? Please check all that apply. Please include pregnancies that ended in miscarriage, abortion or stillbirth. If you had multiple pregnancies in an age grouping, please check the age range and provide further information in the other option ie. "Pregnant at age 22 and 24."

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* 7. Was it more than one pregnancy that you experienced abuse?

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* 8. How many times did you experience abuse while pregnant? Please include any pregnancy that did not come to term or was a still birth.

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* 9. Out of the total number of pregnancies where you experienced abuse, how many did not come to term or were still births?

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* 10. Please check all forms of abuse you experienced during pregnancy

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* 11. Did the friends or family of abuser support the abuse from the abuser or enacted abuse themselves?

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* 12. What was the the type of abuse you experienced from the abuser's family or friends during the pregnancy?

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* 13. Did any of your friends or family sympathize with your abuser, support the abuse from the abuser, or enacted abuse themselves during the pregnancy?

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* 14. What was the the type of abuse you experienced from the your family or friends during the pregnancy?

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* 15. With the pregnancies where you experienced abuse, were there medical complications?

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* 16. What were the medical complications. Include any diagnosis. If no medical complications type "N/A"

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* 17. How did the medical complications impact the embryo or fetus? If there was no impact, type "N/A".

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* 18. How did the medical complications impact you during and after the pregnancy? If no impact, type "N/A".

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* 19. Was your pregnancy considered high-risk?

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* 20. Did the pregnancy end early because of the non-physical and physical domestic violence?

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* 21. Did you make an outcry or share that you were being abused?

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* 22. Who did you report the abuse to? Check all that apply.

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* 23. Did anyone report the abuse to an authority?

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* 24. Which authority was the abuse reported to?

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* 25. What was the outcome of the report? Check all that apply.

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* 26. Was your doctor aware of the domestic violence?

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* 27. Did your doctor speak with you about concerns of your partner? If so, what did they say?

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* 28. List the age (or approximate age) when your child was diagnosed with an adverse outcome. List as such: "Age 5 language disorder, dysgraphia" OR if an approximate age, you can list as: "Age 5/6 language disorder, dysgraphia"/"Kindergarten dysgraphia"

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* 29. Has your child needed assistance in school? If so, please check all that applies.

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* 30. In looking at your personal lineage, has anyone in your maternal lineage or females in your paternal lineage experience non-physical or physical abuse during pregnancy?

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* 31. Would you like ACECC or researchers volunteering with ACECC, to contact you for follow-up questions? 

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* 32. If you would like a follow-up interview, please provide your contact information below. If not, please skip and follow additional instructions to complete the survey.

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